An Unusual Case of Malignant Hypertension and Stress Cardiomyopathy
A 39-year-old man with chronic hypertension presented with perioperative malignant hypertension while undergoing induction for elective surgery. He was treated with intravenous antihypertensives. He reported several years of episodic chest pain, palpitations, and diaphoresis. Transthoracic echocardi...
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| Format: | Article |
| Language: | English |
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American College of Physicians
2022-05-01
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| Series: | Annals of Internal Medicine: Clinical Cases |
| Online Access: | https://www.acpjournals.org/doi/10.7326/aimcc.2021.0056 |
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| author | Anjali Rao Wanpen Vongpatanasin |
| author_facet | Anjali Rao Wanpen Vongpatanasin |
| author_sort | Anjali Rao |
| collection | DOAJ |
| description | A 39-year-old man with chronic hypertension presented with perioperative malignant hypertension while undergoing induction for elective surgery. He was treated with intravenous antihypertensives. He reported several years of episodic chest pain, palpitations, and diaphoresis. Transthoracic echocardiogram demonstrated new-onset cardiomyopathy. Urinary and serum catecholamines were measured and the pattern of catecholamine levels suggested an extra-adrenal source. Computed tomography of the abdomen showed a contrast-enhancing mass in the bladder suspicious for metastatic paraganglioma. The patient had surgical resection with substantial improvement in his hypertension. The presence of labile hypertension and acute cardiomyopathy precipitated by stress should prompt evaluation for a catecholamine-producing tumor and appropriate genetic testing. |
| format | Article |
| id | doaj-art-074cd3e62059410f8b0b35b7cb24a563 |
| institution | DOAJ |
| issn | 2767-7664 |
| language | English |
| publishDate | 2022-05-01 |
| publisher | American College of Physicians |
| record_format | Article |
| series | Annals of Internal Medicine: Clinical Cases |
| spelling | doaj-art-074cd3e62059410f8b0b35b7cb24a5632025-08-20T03:18:49ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642022-05-011310.7326/aimcc.2021.0056An Unusual Case of Malignant Hypertension and Stress CardiomyopathyAnjali Rao0Wanpen Vongpatanasin11University of Texas Southwestern Medical Center, Division of Cardiology, Dallas, Texas1University of Texas Southwestern Medical Center, Division of Cardiology, Dallas, TexasA 39-year-old man with chronic hypertension presented with perioperative malignant hypertension while undergoing induction for elective surgery. He was treated with intravenous antihypertensives. He reported several years of episodic chest pain, palpitations, and diaphoresis. Transthoracic echocardiogram demonstrated new-onset cardiomyopathy. Urinary and serum catecholamines were measured and the pattern of catecholamine levels suggested an extra-adrenal source. Computed tomography of the abdomen showed a contrast-enhancing mass in the bladder suspicious for metastatic paraganglioma. The patient had surgical resection with substantial improvement in his hypertension. The presence of labile hypertension and acute cardiomyopathy precipitated by stress should prompt evaluation for a catecholamine-producing tumor and appropriate genetic testing.https://www.acpjournals.org/doi/10.7326/aimcc.2021.0056 |
| spellingShingle | Anjali Rao Wanpen Vongpatanasin An Unusual Case of Malignant Hypertension and Stress Cardiomyopathy Annals of Internal Medicine: Clinical Cases |
| title | An Unusual Case of Malignant Hypertension and Stress Cardiomyopathy |
| title_full | An Unusual Case of Malignant Hypertension and Stress Cardiomyopathy |
| title_fullStr | An Unusual Case of Malignant Hypertension and Stress Cardiomyopathy |
| title_full_unstemmed | An Unusual Case of Malignant Hypertension and Stress Cardiomyopathy |
| title_short | An Unusual Case of Malignant Hypertension and Stress Cardiomyopathy |
| title_sort | unusual case of malignant hypertension and stress cardiomyopathy |
| url | https://www.acpjournals.org/doi/10.7326/aimcc.2021.0056 |
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